<!DOCTYPE html>
<html>
<meta charset="utf-8">
<head th:include="include :: header"></head>
<body class="gray-bg">
	<div class="wrapper wrapper-content ">
		<div class="row">
			<div class="col-sm-12">
				<div class="ibox float-e-margins">
					<div class="ibox-content">
						<form class="form-horizontal m-t" id="signupForm">
							<input id="agentId" name="agentId" type="hidden">
							<div class="form-group">
								<label class="col-sm-3 control-label">代理商名称：</label>
								<div class="col-sm-8">
									<input id="agentName" name="agentName" class="form-control" type="text">
								</div>
							</div>
							<div class="form-group">
								<label class="col-sm-3 control-label">联系人：</label>
								<div class="col-sm-8">
									<input id="contacts" name="contacts" class="form-control"
										type="text">
								</div>
							</div>
							<div class="form-group">
								<label class="col-sm-3 control-label">联系电话：</label>
								<div class="col-sm-8">
									<input id="tel" name="tel" class="form-control"
										type="text">
								</div>
							</div>
							<div class="form-group">
								<label class="col-sm-3 control-label">微信号：</label>
								<div class="col-sm-8">
									<input id="account" name="account" class="form-control"
										type="text">
								</div>
							</div>
							<div class="form-group">
								<label class="col-sm-3 control-label">后台登录账号：</label>
								<div class="col-sm-8">
									<input id="bgAccount" name="bgAccount" class="form-control"
										type="text">
								</div>
							</div>
							<div class="form-group">
								<label class="col-sm-3 control-label">后台登录密码：</label>
								<div class="col-sm-8">
									<input id="bgPassword" name="bgPassword" class="form-control"
										type="password">
								</div>
							</div>
							<div class="form-group">
								<label class="col-sm-3 control-label">分销比例：</label>
								<div class="col-sm-8">
									<input id="divide" name="divide" class="form-control"
										type="text" oninput="clearNoNum(this)">
								</div>
							</div>
							<div class="form-group">
								<label class="col-sm-3 control-label">备注：</label>
								<div class="col-sm-8">
									<input id="remarks" name="remarks" class="form-control"
										type="text">
								</div>
							</div>
							<div class="form-group">
								<label class="col-sm-3 control-label">状态:</label>
								<div class="col-sm-8">
									<label class="radio-inline"> <input type="radio"
										name="status" value="1" checked="checked" /> 正常
									</label> <label class="radio-inline"> <input type="radio"
										name="status" value="0" /> 禁用
									</label>
								</div>
							</div>
							<div class="form-group">
								<div class="col-sm-8 col-sm-offset-3">
									<button type="submit" class="btn btn-primary">提交</button>
								</div>
							</div>
						</form>
					</div>
				</div>
			</div>
		</div>

	</div>
	<div th:include="include::footer"></div>
	<script type="text/javascript" src="/js/appjs/coach/subAgent/subAgentAdd.js">
	</script>
</body>
</html>
